Device and method for the treatment of intra-abdominal disease

Abstract

An apparatus, such as a medical device, includes an elongate member having a proximal end portion and a distal end portion. The elongate member defines a lumen extending from the proximal end portion to the distal end portion. The distal end portion of the elongate member is configured to be inserted into a body of a patient. The apparatus includes a heating element configured to heat the lumen defined by the elongate member such that a material within the lumen is heated and can be delivered to bodily tissue.

1 . A medical device, comprising:
 an elongate member having a proximal end portion and a distal end portion, the elongate member defining a lumen extending from the proximal end portion to the distal end portion, the distal end portion of the elongate member being configured to be inserted into a body of a patient;   a heating element configured to heat the lumen defined by the elongate member such that a material within the lumen is heated; and   a delivery mechanism operatively coupled to the elongate member, the delivery mechanism configured to move at least a portion of the material through at least a portion of the lumen of the elongate member.   
   
   
       2 . The medical device of  claim 1 , wherein the delivery mechanism is configured to deliver a specified amount of the material through the lumen and onto a target site in the body of the patient. 
   
   
       3 . The medical device of  claim 1 , wherein the delivery mechanism has an actuator and a plunger, the actuator being disposed on the proximal end portion of the elongate member, the plunger being coupled to the actuator, the actuator configured to move the plunger when the actuator is actuated, the plunger configured to move the material through at least a portion of the lumen. 
   
   
       4 . The medical device of  claim 1 , wherein the distal end portion is configured to fit through a trocar having an inner diameter no greater than 10 mm. 
   
   
       5 . The medical device of  claim 1 , further comprising:
 insulation material disposed between an outer surface of the elongate member and at least one of the heating element and the lumen.   
   
   
       6 . The medical device of  claim 1 , wherein the heating element is configured to heat the material to a desired temperature. 
   
   
       7 . The medical device of  claim 1 , the heating element being a first heating element, further comprising a second heating element, the second heating element configured to heat the material as it passes from a first location within the lumen to a second location within the lumen. 
   
   
       8 . The medical device of  claim 7 , further comprising:
 insulation material disposed between the second heating element and an outer surface of the elongate member.   
   
   
       9 . The medical device of  claim 1 , the heating element being a first heating element, further comprising a second heating element configured to maintain the material at a temperature that is within 5° C. of a desired temperature. 
   
   
       10 . The medical device of  claim 1 , wherein the material is configured to necrose bodily tissue at a target site in the body of the patient when the material is heated to a desired temperature. 
   
   
       11 . The medical device of  claim 1 , wherein the material has a low thermal mass. 
   
   
       12 . The medical device of  claim 1 , wherein the material is a polymer. 
   
   
       13 . The medical device of  claim 1 , wherein the material is at least one polymer selected from the group consisting of polyhydoxyalkanoate, low molecular weight polycaprolactone, polyglycolic acid, polylactic-coglycolic acid, polylactic acid, high molecular weight polycaprolactone, poly-3-hydroxybutyrate, and polyglycerol sebacate. 
   
   
       14 . The medical device of  claim 1 , wherein the material is formulated to inhibit adhesion of bodily material to necrosed bodily tissue. 
   
   
       15 . The medical device of  claim 1 , wherein the material comprises:
 a polymer; and   a pharmaceutical agent.   
   
   
       16 . The medical device of  claim 1 , wherein the material includes at least one pharmaceutical agent selected from the group consisting of estrogen, progesterone, progestin, synthetic androgen, GnRH agonist, mifepristone; SPRM, aromatase inhibitor, and non-steroidal anti-inflammatory drug. 
   
   
       17 . The medical device of  claim 1 , wherein the material includes a pharmaceutical agent that is formulated to elute over a pre-determined period of time. 
   
   
       18 . A method of treating disease, comprising the steps of:
 inserting a material formulated to necrose bodily tissue into a proximal portion of a medical instrument;   heating the material within the medical instrument;   inserting a distal end portion of the medical instrument into a bodily cavity; and   delivering an amount of the material to a target site within the bodily cavity.   
   
   
       19 . The method of  claim 18 , wherein heating the material within the medical instrument includes melting the material within the medical instrument. 
   
   
       20 . The method of  claim 18 , further comprising the step of:
 necrosing at least a portion of bodily tissue at the target site within the body cavity.   
   
   
       21 . The method of  claim 18 , wherein the distal end portion is inserted into the body cavity through a trocar. 
   
   
       22 . The method of  claim 18 , further comprising the steps of:
 inserting a second material into the proximal portion of the medical instrument; and   delivering a desired amount of the second material to the target site within the body cavity.   
   
   
       23 . The method of  claim 18 , further comprising the step of:
 actuating a delivery mechanism on the proximal portion of the medical instrument to move the material through a lumen of the medical instrument.   
   
   
       24 . The method of  claim 18 , further comprising the step of:
 positioning the distal end portion of the medical instrument proximate to the target site within the body cavity.   
   
   
       25 . The method of  claim 18 , further comprising the step of:
 insufflating a body cavity.   
   
   
       26 . A medical device, comprising:
 an elongate member having a proximal end portion and a distal end portion, the elongate member defining a lumen extending from the proximal end portion to the distal end portion, the distal end portion of the elongate member being configured to be inserted into a body of a patient, the distal end portion of the elongate member being configured to fit through a trocar;   a heating element configured to heat a biodegradable polymer to a desired temperature within the proximal end portion of the lumen defined by the elongate member;   a delivery mechanism operatively coupled to the elongate member, the delivery mechanism configured to move the polymer from a first location in the lumen of the proximal end portion of the elongate member to a second location in the lumen of the distal end portion of the elongate member; and   an insulation material disposed between an outer surface of the elongate member and at least one of the heating element and the lumen.   
   
   
       27 . The medical device of  claim 26 , wherein the biodegradable polymer is formulated to thermally necrose a controlled area of bodily tissue when the polymer is heated to the desired temperature. 
   
   
       28 . The medical device of  claim 26 , wherein the delivery mechanism is configured to deliver a desired amount of polymer onto a target site in the body of the patient. 
   
   
       29 . The medical device of  claim 26 , wherein the heating element is a first heating element, the medical device further comprising:
 a second heating element disposed within the distal end portion of the elongate member configured to heat the polymer as it passes from a first location within the lumen to a second location within the lumen.